Robotic Total Mesorectal Excision for Rectal Cancer: A Series of 392 Cases and Mid-Term Outcomes from A Single Center in China
Robotic Total Mesorectal Excision for Rectal Cancer: A Series of 392 Cases and Mid-Term Outcomes from A Single Center in China
复制标题
机器人直肠癌全直肠系膜切除术：中国单个中心的 392 例系列病例和中期结果
DOI：
10.1007/s11605-016-3335-4
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发表时间：
2017-03-01
影响因子：
3.2
通讯作者：
Yu, Peiwu
中科院分区：
文献类型：
--
作者：
Tang, Bo;Zhang, Chao;Yu, Peiwu
机器人全直肠系膜切除术（RTME）治疗直肠癌最近已越来越多地使用;技术可行性和短期结果已详细报道。很少有研究提供了大样本量的临床疗效和中期结局。本研究的目的是介绍机器人全直肠系膜切除术治疗直肠癌的肿瘤学疗效和中期结局，并提供我们关于这些手术挑战性问题的经验。患者的特征，围手术期的临床结果，并发症，病理细节，复发，和中期outcome. The手术时间范围从80至388分钟（中位数224分钟）进行了评估。在我们的系列中，没有手术死亡和麻醉并发症。转复率为1.1%（4/392）。术后并发症发生率为10.2%，吻合口漏是最常见的并发症，发生率为4.1%（16/392）。中位失血量为67.5 +/- 34.3（20-600）。平均术后住院时间为12.1 ± 6.1（6-64）。392例病例中有387例（98.7%）周向切除边缘呈阴性。平均收获淋巴结数量为14.6。30天死亡率期间发生了2例死亡。平均随访24个月（3-66个月），有35例死亡。我们的研究结果表明，RTME治疗直肠癌在技术上是可行的，可以产生良好的短期和中期肿瘤结局。
Robotic total mesorectal excision (RTME) for rectal cancer has recently been increasingly used; technical feasibility and short-term outcomes have been reported in detail. Few studies have presented clinical efficacy and mid-term outcomes for a large sample size. The aim of this study is to present oncologic efficacy and mid-term outcomes of robotic total mesorectal excision for rectal cancer and to provide our experiences regarding these surgically challenging issues.Three hundred ninety-two patients received RTME between March 2010 and June 2015. Patient characteristics, perioperative clinical results, complications, pathologic details, recurrence, and mid-term outcomes were evaluated.Duration of surgery ranged from 80 to 388 min (median 224 min). There were no deaths during surgery and no anesthesiology complications in our series. The conversion rate was 1.1% (4/392). The postoperative complication rate was 10.2%; anastomosis leakage was the most common complication with an incidence of 4.1% (16/392). The median blood loss was 67.5 +/- 34.3 (20-600). The mean postoperative hospital stay was 12.1 +/- 6.1 (6-64). Circumferential resection margins were negative in 387 out of 392 cases (98.7%). The mean number of harvested lymph nodes was 14.6. Two deaths occurred during 30-day mortality. At a mean follow-up of 24 months (range 3-66 months), there were 35 deaths.Our results suggest that RTME is technically feasible for rectal cancer and can yield good short- and mid-term oncologic outcomes.